The case describes an event at Hopewell Hospital concerning one of the general surgeons, Dr. Cutrite. E. L. Straight is the director of clinical services at the hospital; he has been working in this position for two years, and he enjoys his job. Although his contribution to the hospital has led to some improvements in care quality, Straight still struggles to resolve problems with a few physicians, Cutrite being one of them. The surgeon has slipped mentally and physically over the years, turning from a brilliant professional to an unreliable employee. Nevertheless, he still possesses great political power, which keeps him safe from potential demotion.
One day, the operating room supervisor tells Straight that during a surgery performed by Cutrite, a plastic needle protector was almost definitely left in a patient’s belly. The scrub nurse working with the surgeon confirms that she did not account for the needle protector at the end of the surgery, which significantly increases the chance of it being left in the patient. Ms. Jameson, the patient in question, cannot be called back into surgery immediately since she has left the hospital the day before yesterday.
Dr. Cutrite refuses to bring the patient back in, stating that the item left in her belly cannot hurt her, aside from some minor discomfort. Moreover, he warns the staff against doing anything that does not align with his judgment of the situation. Straight discusses the outcomes with the chief of surgery, who confirms that the patient is unlikely to experience life-threatening consequences. However, the chief does not dismiss the potential risk, which makes Straight weigh his career at the hospital against Cutrite’s political power.